Advantages of the STN target include more medication reduction, less‐frequent battery changes, and a more favorable economic profile. Off‐period motor symptoms and tremor improve in both targets as well as with either uni‐ or bilateral stimulation. The results of the STN versus GPi “rematch” studies support the conclusion that bilateral STN DBS may not be the best option for every PD surgical patient. Such a tailored approach would include the options of targeting the GPi or choosing a unilateral operation. Since 2005, a series of well‐designed clinical trials and follow‐up studies have addressed the question as to whether a more tailored approach to DBS therapy might improve overall outcomes. This bilateral STN “one‐size‐fits‐all” approach was challenged by an editorial entitled “ STN versus GPi: The Rematch,” which appeared in the Archives of Neurology in 2005. Whereas the GPi target does have a following, most centers have uniformly employed bilateral STN DBS for all PD cases. When formulating a DBS treatment plan for a patient with Parkinson's disease ( PD), two critical questions should be addressed: (1) Which brain target should be chosen to optimize this patient's outcome? and (2) Should this patient's DBS operation be uni‐ or bilateral? Over the past two decades, two targets have emerged as leading contenders for PD DBS the STN and the globus pallidus internus ( GPi).
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